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Original Paper Salvia divinorum use and phenomenology:results from an online survey HR Sumnall 1 , F Measham 2 , SD Brandt 3 and JC Cole 4 Abstract Salvia divinorum is a hallucinogenic plant with ethnopharmacological and recreational uses. It differs from classic serotonergic hallucinogens such asLSD and psilocin in both phenomenology and potent agonist activity of the active component salvinorin A at k -opioid receptors. Awareness of S. divinorum has grown recently, with both an increase in its public representation and concern over its potential harmful effects. This discussion isparticularly relevant as S. divinorum is legal to use in many countries and regions and easily available through online retailers. Drawing upon previousinvestigations of S. divinorum and other hallucinogens, this study surveyed 154 recent users and questioned them on their use behaviours, conse-quences of use and other attitudinal measures. Although reporting an extensive substance use history, and considering the limitations of onlinesurveys, there was little evidence of dysfunctional S. divinorum use, and few reports of troubling adverse consequences of use. Furthermore, there was noevidence that users exhibited increased schizotypy. Respondents reported that S. divinorum produced mixed hallucinogenic and dissociative effects,which lends support to assertions that it phenomenologically differs from other hallucinogens with primary serotonergic activity. The functions of usechanged with greater experiences with the drug, and although many respondents reported use of S. divinorum as an alternative to illegal drugs it, wasapparent that legal proscription would be unlikely to dissuade them from use. These results are discussed with reference to psychopharmacologicallyinformed public health responses to substance use. Keywords Drug effects, hallucinogens, Salvia divinorum , subjective experiences Introduction Salvia divinorum (S. divinorum) has traditional uses as anentheogen and as an ethnopharmacological treatment (Ott,1995), although it is better known in the developed world asa recreational hallucinogen (Khey et al., 2008). The activecomponent salvinorin A is a potent neoclerodane diterpenehallucinogen with selective agonist activity at k -opioid recep-tors (and peripheral actions on cholinergic transmission), dis-tinguishing it from the classic serotonergic hallucinogens suchas LSD and psilocin (see Butelman et al., 2007; Capasso et al.,2006; Ortega et al., 1982; Roth et al., 2002). Further indirectactions on dopaminergic, noradrenergic, and endocannabi-noid systems have also been characterized (Braida et al.,2008, Grilli et al., 2009; Zhang et al., 2005). The drug isactive in humans in doses around 200 m g when administeredthrough vaporization (thus avoiding hepatic first-pass metab-olism), and is orally active when held in the mouth for > 10min (Siebert, 1994). One interesting feature of salvinorinA and its naturally occurring derivatives is the lack of nitro-gen, and it would appear that none of the currently identifiedplant constituents are alkaloids. Other compounds isolatedfrom the plant include Salvinorins B–I (Lee et al., 2005;Munro and Rizzacasa 2003; Shirota et al., 2006; Valde ´set al., 1984, 2001), divinorin F, salvidivins A–D (Shirotaet al., 2006), divinatorins A–F (Bigham et al., 2003; Munroand Rizzacasa, 2003) and salvinicins A and B (Harding et al.,2005). Little is known about whether they would be centrallyactive in humans, but the salvinorin A nucleus provides astructural template for a large number of chemically alteredentities (for example, see Beguin et al., 2006, 2008, 2009).2-Methoxymethyl-salvinorin B, for example, is a morepotent k -opioid receptor agonist than salvinorin A, andshows longer-lasting behavioural activity in murine tests of ambulation and nociception (Wang et al., 2008).To date there have been only a few national estimates of S. divinorum use prevalence in the general population. In theUSA, the National Survey on Drug Use and Health esti-mated that about 1.8 million persons aged 12 or older used 1 Centre for Public Health, Liverpool John Moores University, Liverpool,UK. 2 Department of Applied Social Science, Lancaster University, Lancaster,UK. 3 School of Pharmacy and Biomolecular Sciences, Liverpool John MooresUniversity, Liverpool, UK. 4 School of Psychology, University of Liverpool, Liverpool, UK. Corresponding author: Dr Harry Sumnall, Centre for Public Health, Liverpool John MooresUniversity, Henry Cotton Building, Webster Street, Liverpool L3 2ET, UKEmail:
[email protected] Journal of Psychopharmacology 0(0) 1–12 ! The Author(s) 2010Reprints and permissions:sagepub.co.uk/journalsPermissions.navDOI: 10.1177/0269881110385596 jop.sagepub.com at The John Rylands University Library, The University of Manchester on October 13, 2010 jop.sagepub.comDownloaded from S. divinorum in their lifetime, and approximately 750,000 didso in the previous year (SAMHSA, 2008). Other local andpopulation-specific studies have been conducted. For exam-ple, lifetime prevalence was estimated to be 28.7% and last-year prevalence of 8.8% in readers of the UK dance musicmagazine Mixmag; modal frequency of use was monthly(Winstock, personal communication). In university studentsin Florida (where S. divinorum was legal at the time of thestudy), 11% of males and 4% of females reported a lifetimeuse (Khey et al., 2008). A similar study in California esti-mated last-year prevalence at 4.4% (Lange et al., 2008).Regression analysis in another US college sample showedusers were most likely to be young white males with a highprevalence of cannabis use (Miller et al., 2009). Over half of respondents in an internet-based survey reported reduction orcessation of use in the previous 12months, most commonlyciting dislike of the subjective effects or a loss of interest in S. divinorum (Biglete et al., 2009). In this study, age of initi-ation was related to use function, with young adults reportingusing for fun, whilst older adults cited ‘spiritual’ reasons (notdefined by the authors, but see Saunders et al., 2000, andWilber, 2006, for popular discussions). In retrospective sur-veys of the subjective effects of use, participants typicallyreport a small number of lifetime uses ( n < 20), and a rangeof hallucinogen/psychedelic-like experiences (Baggott et al.,2004). Interestingly, however, these are reported to bequalitatively distinct from those produced by serotonergichallucinogens such as LSD and psilocin. For example, thederealization and physical impairment (similar to that pro-duced by NMDA receptor antagonists) produced by S. divi-norum at typical doses is thought to be unique, as this effect isonly seen at relatively higher doses with other hallucinogens(Arthur, 2008; Ball, 2007; Dalgarno, 2007; Gonza ´lez et al.,2006; Lange et al., 2010; Pendell, 1995). Data on the potentialadverse effects and toxicity of S. divinorum are limited. Over10 years, 37 cases were reported to the California PoisonControl System after intentional exposure to S. divinorum (Vohra et al., 2009). Just under half of these were associatedwith ingestion of S. divinorum alone, and the most commonsymptoms were confusion or disorientation, hallucinations,dizziness, and gastrointestinal disturbances. All patientsrecovered after appropriate intervention. In rats, no signifi-cant effects were seen on heart rate, body temperature, orgalvanic skin response after chronic salvinorin A administra-tion, although an increase in pulse pressure was recorded(Mowry et al., 2003). Furthermore, toxicity was not apparentin mice after chronic administration of 400–6400 m g/kg(around 1–16 times the typical human dose) once daily over2weeks (Mowry et al., 2003).One clinical case report described a 15-year-old malewith a recent history of S. divinorum use presenting with para-noia, de ´ ja ` vu and blunted affect shortly after self-administra-tion of cannabis (Singh, 2007). An 18-year-old female wasadmitted to psychiatric services with acute onset of agitation,disorganization, and hallucinations shortly after smokingcannabis (Paulzen and Gru ¨nder, 2008). It transpired thather partner had added S. divinorum to the herbal cannabissmoking mixture. A 21-year-old man also presented withsymptoms of acute psychosis and paranoia, including echola-lia and psychomotor agitation (Przekop and Lee, 2009).Despite antipsychotic treatment the authors noted that thepatient did not exhibit improvement at 4months’ follow-up.In all three cases, the authors exclusively attributedthese symptoms to S. divinorum because of purported linksbetween k -opioid receptor agonist activity and changes indopaminergic transmission, with psychomimetic symptom-atology (Pfeiffer et al., 1986). However, with respect to thislatter case, it should be noted that chronic psychotic episodesafter hallucinogen use are rare (Strassman, 1984), and theauthors provided no information on treatment adherenceduring this period. In contrast, daily low-dose self-medicationfor depression with orally administered S. divinorum leaveshas been reported, apparently with the full remission of symp-toms (Hanes, 2001).Understanding of the behavioural pharmacology of salvi-norin A is growing. A study investigating the human pharma-cokinetics of smoked salvinorin A had to be abandoned afterthe two volunteers became too intoxicated to provide bloodsamples, although it appeared in urine up to 1.5h after admin-istration, suggesting rapid elimination (Pichini et al., 2005).In non-human primates, the elimination half-life of salvinorinA was 56.6 24.8 minutes after a bolus intravenous (i.v.)administration that was predicted to have the samedisposition as the smoked drug (Schmidt et al., 2005).Sex-dependent pharmacokinetics were also noted, suggestingthe possibility of differences in pharmacology. SalvinorinA produced dose-dependent k -opioid receptor agonist-likeresponse after drug discrimination training with U69,593 inboth rats and rhesus monkeys, supporting the role of thisreceptor in the production of behavioural/subjective effects(Baker et al., 2009; Butelman et al., 2004; Wilmore-Fordham,2007).However, salvinorinAdidnotsubstituteforthe5-HT 2A receptor agonist hallucinogen DOM in rhesus monkeys(Li et al., 2008). As with other k -opioid receptor agonists,administration of salvinorin A attenuated cocaine seeking inrats (Morani et al., 2009) and produced a conditioned placeaversion in mice at high doses (1–3.2mg/kg) (Zhang et al.,2005). This latter effect was similar to that produced by mes-caline (Cappell and LeBlanc, 1971), but not LSD (Meehan andSchechter, 1998), and was associated with a decrease in dopa-mine concentration in the caudate putamen. However, in rats,0.05–160 m g/kg subcutaneous (s.c.) salvinorin A produced aconditioned place preference, and 0.01–1 m g intracerebroven-tricular (i.c.v.) infusions were self administered (Braida et al.,2008). Place preference was also observed in zebra fish (Braidaetal.,2007).Thesefindingssuggestthattherewardingeffectsof salvinorin A may be dose, species, and model specific. In mice,antinociception, sedation, and motor incoordination effectshave been observed (Fantegrossi et al., 2005; McCurdy et al.,2006), and in the forced swim test rats treated with high dosesof salvinorin A showed increased immobility and decreasedswimming, suggesting pro-depressant like effects (Carlezonet al., 2006). However, at lower doses (0.25–2mg/kg), ratsexhibited both anxiolytic and antidepressant effects (Hanes,2001), again suggesting behavioural effects are dose dependent(Braida et al., 2009).Although not a new phenomenon (Hoffmann, 1980), theincreased awareness of the use of S. divinorum has led to bothpublic health and legislative concerns (Bu ¨cheler et al., 2005).Federal legislation against S. divinorum exists only in some 2 Journal of Psychopharmacology 0(0) at The John Rylands University Library, The University of Manchester on October 13, 2010 jop.sagepub.comDownloaded from countries, and there is also legislation in some USA states,although at the time of writing the UK’s Advisory Council onthe Misuse of Drugs (ACMD) is considering providing rec-ommendations for Government on its legal status. This con-cern has partly been driven by perceived ease of access to S. divinorum and other drugs through the internet and citycentre retailers (Dennehy et al., 2005; Halpern and Pope,2001; Hoover et al., 2008; Siemann et al., 2006), and alsoby popular representations of use in the media, particularlythrough new media such as the online YouTube video site(Lange et al., 2010). Other authors have suggested that suchpowerful, but legal, recreational drugs are popular as theyallow intoxication without the need for otherwise law-abidingcitizens to engage with criminal markets (Hammersley, 2010;Measham et al., 2010).This study aimed to provide further clarification of thesubjective effects of S. divinorum , use patterns, and experienceof adverse effects in order to inform psychopharmacologicallybased public health discussions. The present study exploredmultidimensional attitudes regarding S. divinorum which pro-vided a more complete cultural understanding than thatreported by Gonza ´lez et al. (2006). We were also interestedin whether the legality of S. divinorum , and as a consequencerelative ease of availability, was a motivating factor for use.Furthermore, considering the case reports cited abovedescribing psychosis after acute administration, we analysedreporting of schizotypy in the sample to investigate whether S. divinorum users had increased risk of psychosis (Williamset al., 1996). Methods Subjects Participants were recruited by advertisements posted on inter-net sites discussing S. divinorum and other substance use,online retailers, and social networking sites (Facebook,MySpace). Cards advertising the study were also providedto internet and ‘head’/smart shops retailers in the NorthWest of England to include with S. divinorum purchases. Asprevalence is relatively low compared with other recreationaldrugs, convenience sampling was deemed appropriate for thisresearch. The study was advertised as an investigation of theeffects of S. divinorum and was only open to those whoreported using S. divinorum at least once in their lifetime.All potential volunteers were provided with detailed informa-tion about the study and were assured that their responseswould remain confidential. The ethics committee at LiverpoolJohn Moores University gave their approval for this researchstudy and all subjects were required to give informed consentafter reading a description of the investigation. Questionnaire design Volunteers were required to complete a single onlinequestionnaire hosted by Bristol Online Surveys (http://www.survey.bris.ac.uk/). The questionnaire asked for participantdemographic information and a detailed history of use of awide variety of substances. The time of survey submission andpatterns of answers were inspected to reduce the chance thatindividuals had submitted more than one survey. The Severityof Dependence Scale (SDS) (Gossop et al., 1995) was includedto assess dependence upon S. divinorum . Although this scalehas not been previously validated for S. divinorum it wasbelieved that this would provide important preliminary infor-mation on the likelihood of use disorders. Furthermore, theSDS yields robust assessments on a range of abused drugs.The next section requested information on S. divinorum purchasing patterns, including those formulations usuallypurchased, sources of purchases, and reasons for use(e.g. ‘interest in drug-induced states of consciousness’; ‘curi-osity’). Participants were then asked to think about their mostrecent (representative) S. divinorum experiences (for example,length of experience, circumstances surrounding use), andwere presented with a list of 31 statements that describedtypical subjective effects of classical hallucinogens and relateddrugs. Items were generated from earlier informal interviewswith hallucinogen users, personal communications with col-leagues, and also adapted from literature describing the acuteand immediate recreational effects of S. divinorum (Albertsonand Grubbs, 2009; Dalgarno, 2007; Gonza ´lez et al., 2006).Further items were adapted from the PsychedelicExperience Questionnaire (Pahnke and Richards, 1966) andthe ecstasy effect experiences questionnaire (Sumnall et al.,2006). Participants were asked to indicate how often theyexperienced each particular effect or event listed aftertaking S. divinorum by selecting a number along a five-point Likert scale. Finally, the questionnaire included thecognitive–perceptual subscale of the schizotypy personalityquestionnaire (SPQ) (Raine, 1991). In normal populations,the mean score of the subscale is 11.7 7.4 (Raine, 1992). Statistical analyses Preliminary data screening reduced the number of scale vari-ables included in subsequent analyses. Briefly, we identifiedand removed items with limited range (i.e. all points on thescalenotused)and/orwithhigh/lowstandarddeviation.Otheritems were considered for removal if they yielded statisticallysignificant skewness and kurtosis distribution scores, or if theydid not significantly correlate at 1% or 5% significance levels,along with items correlating too highly with many other itemsto avoid multicollinearity. This resulted in the exclusion of twoitems (‘On salvia I found it hard to take on ordinary socialroles’; ‘On salvia I thought more in images than in abstractthoughts’). The remaining variables were entered into a prin-cipal components analysis (PCA) with Scree plot criterion todetermine the number of components to be entered into obli-que direct oblimin rotation. Before final analysis of theextracted components, the anti-image matrix was examinedto enable removal of partially correlated items. Factor-basedscale scores were generated and subscales were explored as afunction of use intention, patterns of drug use and demo-graphics using a variety of statistical techniques. SPSS v18.0was used for all analysis; significance was set at p < 0.05. Results In total, 209 people began the survey, and 155 completedit (74.2% completion rate). Reasons for non-completion Sumnall et al. 3 at The John Rylands University Library, The University of Manchester on October 13, 2010 jop.sagepub.comDownloaded from are unknown. Non-completers were equally likely as com-pleters to be male, resident in the UK or USA, and reportsimilar ages and drug use histories. Unfortunately not enoughdata were submitted to compare scale scores. Data from oneparticipant who had completed the whole survey wereexcluded as deliberately misleading answers were provided.Of the 154 analysed datasets, 128 (83.1%) were from malesand 26 (16.9%) females. The mean age of respondents was24.7 8.7 years, and 135 (87.7%) self reported their ethnicityas Caucasian. In total, 59 (38.3%) had completed at least anundergraduate university degree, with the majority of othersreporting either completing further, or some higher educa-tion. The modal occupation was student ( n ¼ 54, 35.1%),and other respondents were either employed ( n ¼ 67, 43.5%)or unemployed ( n ¼ 13; 8.4%). The majority of respondentslived in the United States ( n ¼ 92, 59.7%), followed by theUnited Kingdom ( n ¼ 29; 18.8%). Drug use history Table 1 shows substance use histories. No one reported use of naloxone, which was included to help verify accuracy of reporting. After S. divinorum , the most frequently reportedsubstances were alcohol, cannabis, tobacco, and psilocybinmushrooms. Almost three-quarters of respondents reporteduse of S. divinorum in the previous year (73.4%), suggesting just over one-quarter had either ceased or reduced their useafter their initial use, and subjects estimated that they used ittwice a month during regular use periods. On average, timesince last use in those reporting use in the previous year was10 days (range 1–30 days). The mean SDS score for S. divi-norum in previous year users was 0.4 1.4 (range 0–10); fiverespondents scored above 4, suggesting the presence of a usedisorder. S. divinorum use history The age of first use of S. divinorum was 21.7 7.9 years (range13–65 years). It was most frequently obtained from ‘head’/smart shops ( n ¼ 85), followed by online retailers ( n ¼ 67),friends and relatives ( n ¼ 37), cuttings from a live plant( n ¼ 15), and from illegal drug dealers ( n ¼ 2). It was usuallytaken at home (74% of respondents) or outdoors (excludingmusic festivals) (20.8%). Of those who bought it from ‘head’/smart shops, 84.6% reported that it was usually on clear dis-play (as opposed to having to ask specifically for it). Table 2shows the formulations usually purchased. Some 40 subjects(26%) reported that they used S. divinorum as an alternativeto illegal drugs. Of these, 27.5% reported they did so becausethey did not wish to break the law; 27.5% because theywanted to try a new experience; 22.5% because they preferrednatural products; 17.5% because it produced similar effects toillegal hallucinogens such as LSD and mushrooms; and 5%because it was considered easier to obtain than illegal drugs. Table 1. Drug use characteristics in Salvia divinorum users. All values are mean SD% reporting 1use in lifetime( n ¼ 154)% reporting usein previous year Self-reported usesin typical monthin previous year 1 Days sincelast use 2 Alcohol 95.5 89.6 7.7 7.4 5.2 6.5Amphetamine sulphate 40.3 21.4 9.4 10.9 7.1 7.9Anabolic steroids 2.6 1.3 6.5 7.8 1.0 0.0BZP 3 13.6 6.5 3.2 4.7 10.3 11.4Cannabis 95.5 84.4 15.5 11.4 4.9 6.5Cocaine (powder) 48.7 20.1 4.3 6.2 11.3 10.3Cocaine (crack) 12.3 1.9 9.5 0.7 4.0 0.0GHB 4 8.4 1.9 4.0 2.2 5.5 2.1Glue/solvents 9.1 1.9 2.3 2.3 4.5 0.7Heroin 14.3 8.0 5.1 5.5 8.2 11.2MDMA (Ecstasy) 63.6 39.0 1.9 1.9 12.0 8.8Ketamine 28.6 12.3 2.6 1.9 9.4 9.2LSD 5 54.5 33.1 1.5 1.3 12.3 9.5Methamphetamine 14.3 5.2 3.7 3.9 15.0 13.0Mushrooms 6 80.5 42.9 2.0 2.9 14.2 9.3Amyl nitrate ‘Poppers’ 24.0 6.5 4.4 7.7 11.5 6.4Salvia Divinorum 100.0 73.4 1.8 1.9 10.0 9.3Spice 7 20.3 16.2 3.8 3.8 12.1 11.8TFMPP 8 4.5 2.6 0.7 0.5 20.0 0.0Tobacco 85.7 56.5 18.0 12.8 4.0 6.9Tranquilisers 9 33.8 16.9 – 10.3 9.1Sildenafil (Viagra) 9.7 8.0 – 6.0 1.0 1 In those who reported use in the previous year; 2 in those who reported use in the last month; 3 1-benzylpiperazine; 4 g -hydroxybutyrate; 5 Lysergic Acid Diethylamide; 6 typically Psilocybe Semilanceata , Psilocybe Cubensis , and Psilocybe Mexicana ; 7 Spice is the generic name of a smoking mixture consisting of synthetic cannabinoids added to aherbal substrate; 8 1-(3-(Trifluoromethyl)phenyl) piperazine; 9 any form of anxiolytic or hypnotic drug. 4 Journal of Psychopharmacology 0(0) at The John Rylands University Library, The University of Manchester on October 13, 2010 jop.sagepub.comDownloaded from If S. divinorum was made illegal in their country, 72.1%reported that they would continue using it, and 79.9%would continue to use if a supply could be guaranteed.There was no difference in lifetime and last-year drug useprevalence between those who reported using S. divinorum as an alternative to illegal drugs and those who did not(data not shown). Of the sample, 60.4% thought that it waseither important or extremely important to them that S. divi-norum was legal, 13.6% thought it was either slightly or not atall important, and 26% neither important nor unimportant.A third (33.2%) of respondents reported taking other drugs atthe same time ( 1–2h) as S. divinorum , including alcohol(13.7% of respondents); cannabis (33.2%); and other halluci-nogens (6.6%).Participants were asked to report S. divinorum use func-tions, differentiating between their first use, and more recentoccasions (if different). These are shown in Table 3. Thereappeared to be changes in the proportion endorsing eachuse function as experience with S. divinorum increased. Forexample, whilst 13.6% reported use for personal ‘psychother-apy’ at initiation, this had increased to 61.1% at the mostrecent episode; conversely, endorsement of curiositydecreased from 82.5 to 29.2%.Comparing use behaviours in young ( < 21 years, n ¼ 103)versus adult ( > 21 years, n ¼ 51) initiates, it was found thatyounger initiates were just as likely to use S. divinorum indoors (odds ratio (OR) ¼ 0.44, CI ¼ 0.17–1.15, p ¼ 0.08),and to purchase from an online or ‘head’/smart shops(OR ¼ 1.59, CI ¼ 0.75–3.37, p ¼ 0.23) as older initiates.Examining use functions, younger initiates were much morelikely to report using S. divinorum at both the first and mostrecent episode ‘For fun’ (OR ¼ 7.01, CI ¼ 3.16–15.59, p < 0.001; OR ¼ 2.89, CI ¼ 1.23–6.80, p < 0.05, respectively).Differences in the likelihood of endorsement of other usefunctions were non-significant (data not shown).Respondents were asked to estimate the time course of their most recent S. divinorum experience. The total experi-ence was estimated to last for 21.8 25.2min; initial effectsafter ingestion were felt after 1.3 2.9min; subsequent onsetto peak subjective effects lasted for 2.3 10.1min, and lastedfor 8.4 8.7min; S. divinorum effects took approximately14.3 24.5min to subside, and after effects 52.7 429.6min(this large SD was attributed to one respondent who reportedresidual effects up to 80h after administration).A range of adverse effects was reported after administra-tion of S. divinorum , including; excessively intense experience(reported by 51.9%); unexpected effects (46.1%); loss of con-trol over the experience (42.2%); heaviness of head, likesmoking too many cannabis joints (27.9%); unpleasant phys-ical effects (27.3%); unreliable effects (27.3%); tiredness(24.7%); dizziness (22.1%); grogginess (21.4%); mental slow-ness (20.8%); physically exhaustion (17.5%); and unpleasantafter effects (16.2%).Participants were presented with a range of S. divinorum -related behaviours and first asked to rate acceptability andthen to indicate whether they had ever undertaken it(Table 4). Subjects showed disapproval of a range of publicand social use behaviours, especially those involving decep-tion and social responsibilities. Principal component analysis The Kaiser–Meyer–Olkin measure of sampling adequacy was0.797, indicating the solution was robust (Hutcheson andSofroniouo, 1999). The Bartlett’s test of sphericity was signif-icant ( p < 0.001), indicating the srcinal correlation matrixwas not an identity matrix. Items were removed from thesolution if loadings were less than 0.40 on primary Table 2. Preparations of Salvia usually purchased by the sample. Extracts (5–60 ) refer to ‘strength’ of preparations sold by retailers, although nounits of measurement are provided. For example 1 usually refers to the natural potency of the plant ( 2.5mg/g), whilst 10 would be ten times thepotency of 1 . These ‘doses’ are often subjective and are also partly determined by the age and water weight of the plant (Wolowich et al., 2006; Vohraet al., 2009)Extract 5 10 20 40 60 Other % ( n ¼ 286 mentions) 18.2 8.0 31.1 10.5 8.0 24.2Dried leaf 28 g 56 g 100 g 200 g Other ( n ¼ 66) 54.5 21.2 3.0 3.0 18.3Tincture 2mL 10mL Other ( n ¼ 19) 42.1 47.3 10.6Other forms Whole plants; cuttings; extraction using whole leaf and acetone; fresh leaf; extracted Salvinorin A; pre-rolled joints Table 3. Endorsed Salvia use functions on first and recent occasions.Shown are percentages, totals > 100% as participants could report morethan one functionFunction% reportingFirst use Most recent useAs part of a personal ‘psychotherapy’ 13.6 61.1Curiosity 82.5 29.2For (self-defined) spiritual purposes 49.4 87.0For fun 48.7 56.5For social purposes 11.7 7.1Interest in drug-induced states of consciousness81.2 61.7To enhance creativity 11.0 19.5To enjoy music 5.8 17.8To feel close to nature 11.7 23.4 Sumnall et al. 5 at The John Rylands University Library, The University of Manchester on October 13, 2010 jop.sagepub.comDownloaded from
